Healthcare Provider Details

I. General information

NPI: 1639929136
Provider Name (Legal Business Name): SARAH IRENE SNYDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 11/02/2024
Certification Date: 11/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22101 MOROSS RD
DETROIT MI
48236-2148
US

IV. Provider business mailing address

525 W 24TH ST APT 4103
HOUSTON TX
77008-2810
US

V. Phone/Fax

Practice location:
  • Phone: 313-343-4000
  • Fax: 313-343-4056
Mailing address:
  • Phone: 832-444-8998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: